Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $216.90 / $470.67 / $722.28	Facility		$216.90	$470.67	$722.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.74 / $216.90 / $274.98	Professional		$216.74	$216.90	$274.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $234.25 / $371.98 / $618.16	Facility		$234.25	$371.98	$618.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $247.26 / $365.69	Professional		$216.90	$247.26	$365.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $216.90 / $216.90 / $326.25	Facility		$216.90	$216.90	$326.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $216.90 / $292.82	Professional		$216.90	$216.90	$292.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.63 / $212.12 / $216.90	Facility		$204.63	$212.12	$216.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $216.90 / $274.32	Professional		$216.90	$216.90	$274.32
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $212.12 / $212.12 / $216.90	Facility		$212.12	$212.12	$216.90
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $216.90 / $306.94	Professional		$216.90	$216.90	$306.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $216.74 / $242.92 / $296.80	Professional		$216.74	$242.92	$296.80
United Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $216.90 / $255.94	Professional		$216.90	$216.90	$255.94